Background:Primary dysmenorrhea(PD)is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life.In Chinese medicine,navel therapy,treatme...Background:Primary dysmenorrhea(PD)is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life.In Chinese medicine,navel therapy,treatment provided at Shenque(CV 8),is used as a treatment option for PD.Objective:To evaluate the effect of navel therapy on pain relief and quality of life in women with PD,compared with Western medicine(WM).Methods:China National Knowledge Infrastructure(CNKI),Chinese Scientific Journal Database(VIP),Sino Med and Wanfang Database,MEDLINE,the Cochrane Library,Embase,Web of Science,and the International Clinical Trial Registry of the U.S.National Institutes of Health were searched from their inceptions to April 1,2021.Randomized controlled trials(RCTs)assessing therapeutic effects of navel therapy on PD were eligible for inclusion.Rev Man 5.4 software was used for data analyses.The certainty of the evidence was assessed using the online GRADEpro tool.Results:Totally 24 RCTs involving 2,614 participants were identified.Interventions applied to acupuncture point CV 8 included:herbal patching,moxibustion or combined navel therapy(using at least 2 types of stimulation).Compared to placebo,there was a significant effect in favor of navel therapy on reducing overall menstrual symptom scores at the end of treatment[mean difference:-0.82,95%confidence interval(CI):-1.00 to-0.64,n=90;1 RCT].As compared with Western medicine,navel therapy had a superior effect on pain intensity as assessed by Visual Analogue Scale at the end of treatment[standardized mean difference(SMD):-0.64,95%CI:-1.22 to-0.06,I^(2)=80%,n=262;3 RCTs];on symptom resolution rate at 3-month follow-up(risk ratio:1.94,95%CI:1.47 to 2.56,n=1527,I^(2)=38%;13 RCTs);and on global menstrual symptoms score at the end of treatment(SMD:-0.67,95%CI:-0.90 to-0.45,I^(2)=63%,n=990;12 RCTs).Subgroup analyses showed either a better or an equivalent effect comparing navel therapy with Western medicine.No major adverse events were reported.The methodological quality of included trials was poor overall.Conclusions:Navel therapy appears to be more effective than Western medicine in decreasing menstrual pain and improving overall symptoms of PD.However,these findings need to be confirmed by well-designed clinical trials with adequate sample size(Systematic review registration at PROSPERO,No.CRD42021240350).展开更多
Objective:Since December 2019,an outbreak of corona virus disease 2019(COVID-19)occurred in Wuhan,and rapidly spread to almost all parts of China.This was followed by prevention programs recommending Chinese medicine(...Objective:Since December 2019,an outbreak of corona virus disease 2019(COVID-19)occurred in Wuhan,and rapidly spread to almost all parts of China.This was followed by prevention programs recommending Chinese medicine(CM)for the prevention.In order to provide evidenee for CM recommendations,we reviewed ancient classics and human studies.Methods:Historical records on prevention and treatment of infections in CM classics,clinical evidence of CM on the prevention of severe acute respiratory syndrome(SARS)and H1N1 in flue nza,and CM preve ntion programs issued by health authorities in China since the COVID-19 outbreak were retrieved from differe nt databases and websites till 12 February,2020.Research evide nee in eluded data from clinical trials,cohort or other population studies using CM for preventing contagious respiratory virus diseases.Results:The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi's Internal Classic(Huang Di Nei Jing)where preventive effects were recorded.There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza.None of the participants who took CM contracted SARS in the 3 studies.The infection rate of H1N1 in flue nza in the CM group was significantly lower than the non-CM group(relative risk 0.36,95%confidence interval 0.24-0.52;n=4).For prevention of COVID-19,23 provinces in China issued CM programs.The main principles of CM use were to tonify qi to protect from external pathoge ns,disperse wind and discharge heat,and resolve damp ness.The most frequently used herbs in eluded Radix astragali(Huangqi),Radix glycyrrhizae(Gancao),Radix saposhnikoviae(Fangfeng),Rhizoma Atractylodis Macrocephalae(Baizhu),Lonicerae Japonicae Flos(Jinyinhua),and Fructus forsythia(Lianqiao).Conclusions:Based on historical records and human evidenee of SARS and H1N1 influenza prevention,Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population.Prospective,rigorous population studies are warranted to confirm the potential preventive effect of CM.展开更多
Objective:To review the systematic reviews of acupuncture for diabetic peripheral neuropathy(DPN)and to provide evidence for clinical decisions.Methods:Published systematic reviews targeting acupuncture treatment of D...Objective:To review the systematic reviews of acupuncture for diabetic peripheral neuropathy(DPN)and to provide evidence for clinical decisions.Methods:Published systematic reviews targeting acupuncture treatment of DPN were searched using computer through both Chinese and English databases till July 1,2019.Two researchers screened the papers based on inclusion and exclusion criteria and conducted report quality evaluation,methodological quality assessment and evidence quality grading using the preferred reporting items for systematic reviews and meta-analyses(PRISMA),assessment of multiple systematic review 2(AMSTAR 2)and grading of recommendations assessment,development and evaluation(GRADE).Results:Ten systematic reviews were included,involving 11 outcome measures.According to PRISMA,6 items were sufficiently reported while 1 item was not;AMSTAR 2 appraised that all the included systematic reviews were of low quality in the methodological evaluation;according to GRADE,of the 30 clinical evidences,only 5 were graded moderate while the remained were graded low or extremely low.Descriptive analysis showed that acupuncture can significantly improve DPN symptoms,accelerate the conduction velocities of sensory and motor nerves,and up-regulate the content of plasma nitric oxide(NO),while the adverse reaction rate was low.Conclusion:Acupuncture can produce satisfactory clinical efficacy in treating DPN,but the existing problems,such as low-quality evidence,unitary outcome measures,poor methodological quality of systematic reviews and nonstandard reporting,need to be treated cautiously;meanwhile,more high-quality clinical trials are required to elevate the level of evidence.展开更多
基金Supported by Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(No.ZYYCXTD-C-202006)Longitudinal Development Funding of Beijing University of Chinese Medicine(No.2021-ZXFZJJ-016)+1 种基金the National Institute for Health Research(No.SPCR-143)Shanxi Provincial Health Commission Project(No.2020050)。
文摘Background:Primary dysmenorrhea(PD)is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life.In Chinese medicine,navel therapy,treatment provided at Shenque(CV 8),is used as a treatment option for PD.Objective:To evaluate the effect of navel therapy on pain relief and quality of life in women with PD,compared with Western medicine(WM).Methods:China National Knowledge Infrastructure(CNKI),Chinese Scientific Journal Database(VIP),Sino Med and Wanfang Database,MEDLINE,the Cochrane Library,Embase,Web of Science,and the International Clinical Trial Registry of the U.S.National Institutes of Health were searched from their inceptions to April 1,2021.Randomized controlled trials(RCTs)assessing therapeutic effects of navel therapy on PD were eligible for inclusion.Rev Man 5.4 software was used for data analyses.The certainty of the evidence was assessed using the online GRADEpro tool.Results:Totally 24 RCTs involving 2,614 participants were identified.Interventions applied to acupuncture point CV 8 included:herbal patching,moxibustion or combined navel therapy(using at least 2 types of stimulation).Compared to placebo,there was a significant effect in favor of navel therapy on reducing overall menstrual symptom scores at the end of treatment[mean difference:-0.82,95%confidence interval(CI):-1.00 to-0.64,n=90;1 RCT].As compared with Western medicine,navel therapy had a superior effect on pain intensity as assessed by Visual Analogue Scale at the end of treatment[standardized mean difference(SMD):-0.64,95%CI:-1.22 to-0.06,I^(2)=80%,n=262;3 RCTs];on symptom resolution rate at 3-month follow-up(risk ratio:1.94,95%CI:1.47 to 2.56,n=1527,I^(2)=38%;13 RCTs);and on global menstrual symptoms score at the end of treatment(SMD:-0.67,95%CI:-0.90 to-0.45,I^(2)=63%,n=990;12 RCTs).Subgroup analyses showed either a better or an equivalent effect comparing navel therapy with Western medicine.No major adverse events were reported.The methodological quality of included trials was poor overall.Conclusions:Navel therapy appears to be more effective than Western medicine in decreasing menstrual pain and improving overall symptoms of PD.However,these findings need to be confirmed by well-designed clinical trials with adequate sample size(Systematic review registration at PROSPERO,No.CRD42021240350).
基金Supported by the National Natural Science Foundation of China(No.81830115),ChinaProf.Nicola Robinson(visiting professor of Beijing University of Chinese Medicine)is supported by the Overseas Expertise Project,Ministry of Education of China(No.MS20080009)。
文摘Objective:Since December 2019,an outbreak of corona virus disease 2019(COVID-19)occurred in Wuhan,and rapidly spread to almost all parts of China.This was followed by prevention programs recommending Chinese medicine(CM)for the prevention.In order to provide evidenee for CM recommendations,we reviewed ancient classics and human studies.Methods:Historical records on prevention and treatment of infections in CM classics,clinical evidence of CM on the prevention of severe acute respiratory syndrome(SARS)and H1N1 in flue nza,and CM preve ntion programs issued by health authorities in China since the COVID-19 outbreak were retrieved from differe nt databases and websites till 12 February,2020.Research evide nee in eluded data from clinical trials,cohort or other population studies using CM for preventing contagious respiratory virus diseases.Results:The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi's Internal Classic(Huang Di Nei Jing)where preventive effects were recorded.There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza.None of the participants who took CM contracted SARS in the 3 studies.The infection rate of H1N1 in flue nza in the CM group was significantly lower than the non-CM group(relative risk 0.36,95%confidence interval 0.24-0.52;n=4).For prevention of COVID-19,23 provinces in China issued CM programs.The main principles of CM use were to tonify qi to protect from external pathoge ns,disperse wind and discharge heat,and resolve damp ness.The most frequently used herbs in eluded Radix astragali(Huangqi),Radix glycyrrhizae(Gancao),Radix saposhnikoviae(Fangfeng),Rhizoma Atractylodis Macrocephalae(Baizhu),Lonicerae Japonicae Flos(Jinyinhua),and Fructus forsythia(Lianqiao).Conclusions:Based on historical records and human evidenee of SARS and H1N1 influenza prevention,Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population.Prospective,rigorous population studies are warranted to confirm the potential preventive effect of CM.
文摘Objective:To review the systematic reviews of acupuncture for diabetic peripheral neuropathy(DPN)and to provide evidence for clinical decisions.Methods:Published systematic reviews targeting acupuncture treatment of DPN were searched using computer through both Chinese and English databases till July 1,2019.Two researchers screened the papers based on inclusion and exclusion criteria and conducted report quality evaluation,methodological quality assessment and evidence quality grading using the preferred reporting items for systematic reviews and meta-analyses(PRISMA),assessment of multiple systematic review 2(AMSTAR 2)and grading of recommendations assessment,development and evaluation(GRADE).Results:Ten systematic reviews were included,involving 11 outcome measures.According to PRISMA,6 items were sufficiently reported while 1 item was not;AMSTAR 2 appraised that all the included systematic reviews were of low quality in the methodological evaluation;according to GRADE,of the 30 clinical evidences,only 5 were graded moderate while the remained were graded low or extremely low.Descriptive analysis showed that acupuncture can significantly improve DPN symptoms,accelerate the conduction velocities of sensory and motor nerves,and up-regulate the content of plasma nitric oxide(NO),while the adverse reaction rate was low.Conclusion:Acupuncture can produce satisfactory clinical efficacy in treating DPN,but the existing problems,such as low-quality evidence,unitary outcome measures,poor methodological quality of systematic reviews and nonstandard reporting,need to be treated cautiously;meanwhile,more high-quality clinical trials are required to elevate the level of evidence.